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Biomedical subjects

G L Buraggi

Publications and source records attributed to G L Buraggi.

At least 19 recordsLinked to original sources
PubMed1995

Single-dose intraperitoneal radioimmunotherapy with the murine monoclonal antibody I-131 MOv18: clinical results in patients with minimal residual disease of ovarian cancer.

Sixteen of 19 enrolled patients with minimal residual disease of ovarian cancer (macroscopic disease < 5 mm or positive blind biopsies and/or positive peritoneal washing), demonstrated by surgical second-look, underwent intraperitoneal radioimmunotherapy (RIT) with the radiolabelled monoclonal antibody I-131 MOv18 (mean dose 14 mg of MOv18 with 3700 GBq of I-131) 30-40 days after the second-look procedure. Clinical follow-up and/or third-look evaluation performed 90 days after RIT showed complete response (CR) in 5 patients, no change (NC) in 6 patients and progressive disease (PD) in 5 patients. Follow-up study showed long-term maintained CR in 1 patient (34 months) and relapses in the other 4 patients after a mean disease-free period of 10.5 months. 5 NC patients showed clinical or instrumental progression after a mean disease-free period of 13 months. The toxicity of RIT was negligible. Only 1 patient showed mild and transient bone marrow suppression (platelet count nadir 52,000 mm3 after 30 days). HAMA production was demonstrated in 94% (15/16) of patients. In conclusion, RIT appears to be a very promising therapeutic approach to treat minimal residual disease of ovarian cancer.

Adult↗
PubMed1995

Somatostatin receptor imaging of small cell lung cancer (SCLC) by means of 111In-DTPA octreotide scintigraphy.

Somatostatin receptors have been described on the membrane of neoplastic cells derived from the APUD system and their expression has also been demonstrated on small cell lung cancer (SCLC) in vitro and in vivo. 21 patients with SCLC were studied using 111In-octreotide (111In-OCT) scintigraphy. Scintigraphic examinations were performed following intravenous (i.v.) injection of 111 MBq 111In-OCT with whole-body scintigraphy and planar scintigraphy of the thorax as well as the SPET technique. No short-term side effects were described following 111In-OCT administration. We studied the 111In-OCT biodistribution in 3 patients with serial scintigraphies at 1, 5 and 24 h. We used the 5 h as standard scanning time for the following 18 patients. The scintigraphic results were compared with those of other conventional diagnostic procedures. 111In-OCT detected 86% (48/56) of the lesions already known at the time of scintigraphy. It was positive in all 20 SCLC patients and negative in one lung adenocarcinoma. 111In-OCT showed high sensitivity for mediastinal metastases (94%) and good sensitivity for bone metastases (75%) and abdominal lymph node metastases (71%). 111In-OCT did not detect two liver metastases. 111In-OCT detected five unknown lesions which were confirmed by other diagnostic examinations. 111In-OCT was also effective in cancer patients with low levels of NSE. Our study shows that 111In-OCT scintigraphy is a reliable, non-invasive technique to detect primary SLCL and its locoregional or distant metastases. The clinical utility of receptor status characterisation obtained with 111In-OCT scintigraphy should be evaluated by means of an appropriate prospective study.

Aged↗
PubMed1994

Comparison of radioimmunodetection with other imaging methods in evaluating local relapses of colorectal carcinoma.

BACKGROUND: The prognosis for colorectal cancer patients is related closely to the extent of tumor at the time of diagnosis, and early detection of metastatic or recurrent disease is an important prerequisite for successful treatment. Radioimmunodetection is a relatively new technique to image colorectal cancer using radiolabelled monoclonal antibodies (MoAb). The goal of this study was to evaluate the clinical use of radioimmunodetection with the anti-carcinoembryonic antigen MoAb FO23C5, radiolabelled with 131I, in patients submitted to surgery for colorectal cancer and with suspected local recurrences. The results of radioimmunodetection were compared with those of computed tomography, ultrasonography, magnetic resonance imaging, and other diagnostic techniques (gastrointestinal x-ray, endoscopy, and, in selected cases, a surgical second look). METHODS: Fifty-nine patients with a rise in carcinoembryonic antigen serum levels or a clinical suspicion of recurrences entered the study. Scintigraphy was performed at multiple interval times (4-100 hours) after an intravenous injection of radiolabelled FO23C5 F(ab')2 fragments. RESULTS: The cumulative results showed the high sensitivity (89%), specificity (78%), and accuracy (86%) of radioimmunodetection. Of the radiologic methods, only magnetic resonance imaging had the same accuracy (86%), with lower specificity (64%) and higher sensitivity (93%). Computed tomographic scan and ultrasonography displayed the poorest accuracy (68% and 47%, respectively). CONCLUSIONS: Radioimmunodetection is an important imaging technique that can be used in clinical practice for the follow-up of the patient with colorectal carcinoma.

Antibodies, Monoclonal↗
PubMed1994

111In-octreotide uptake in granulomatous and tumor lesions in a patient with small-cell lung cancer.

A case of a patient with small cell lung cancer and right submandibular node enlargement due to granulomatous lymphadenitis is presented. Diagnostic procedures included: biopsy of the cervical node, transmission computed tomography of the chest, bronchoscopic examination and biopsy of the pulmonary lesion. The patient underwent 111In-octreotide scintigraphy (whole body and single photon emission tomography) which revealed both lesions. We conclude that granulomatous lesions are to be considered as a possible cause of false positive results, when octreotide scintigraphy is used to evaluate distant metastases in patients with known cancer.

Carcinoma, Small Cell↗
PubMed1994

Scintigraphic detection of melanoma metastases with a radiolabeled benzamide ([iodine-123]-(S)-IBZM).

UNLABELLED: Iodine-123-(S)-2-hydroxy-3-iodo-6-methoxy-N-[(1-ethyl-2-pyrrolidinyl) methyl] benzamide ([123I]-(S)-IBZM) is a radiolabeled benzamide usually employed to study neuropsychiatric disorders, such as schizophrenia and Parkinson's disease. The ectodermic origin of melanocytes and the presence of melanin in the substantia nigra are the theoretic basis of the experimental use of this class of tracers for melanoma imaging. METHODS: Eleven patients with proven metastatic melanoma entered the study. Whole-body and planar scintigrams were performed 2, 4 and 24 hr after intravenous injection of a mean tracer activity of 205 MBq. The dosimetric evaluation was performed by the Medical Internal Radiation Dose Committee method. RESULTS: The [123I]-(S)-IBZM scans allowed the detection of all six cutaneous lesions, five of six superficial pathologic lymph nodes, four of five pulmonary and one of two hepatic metastases. The maximum tumor-to-background ratio was 2.6 in planar images. The hepatobiliary excretion of the tracer may limit detection of intra-abdominal lesions. Dosimetry is similar to data for nononcologic patients. CONCLUSION: Although it is unclear if the mechanism of radiopharmaceutical uptake in melanoma is due to binding to membrane receptors or due to interactions with intracellular structures, radiolabeled benzamide is a promising tracer to detect melanoma.

Adult↗
PubMed1993

Current role of gallium scan and magnetic resonance imaging in the management of mediastinal Hodgkin lymphoma.

BACKGROUND: A residual mediastinal mass after treatment represents a common diagnostic problem in the management of patients with Hodgkin lymphoma (HD). Conventional diagnostic radiology, computed tomography (CT), or ultrasonography (US) do not adequately reflect changes as fibrosis or necrosis. Gallium-67 (67Ga) imaging has been proven to be useful for the evaluation of HD in the mediastinum. The authors compared the ability of gallium scan and magnetic resonance imaging (MRI) to evaluate the mediastinal disease in the follow-up of patients with HD. METHODS: Thirty-four patients previously treated for HD were investigated with gallium scan, MRI, and all the other investigations to evaluate the mediastinal region. Sixteen patients were in restaging after treatment, and 18 were investigated for suspected radiologic recurrence in the mediastinum (follow-up, 9-75 months). The results of gallium scan and MRI were matched with clinical findings during the follow-up. RESULTS: A sensitivity of 85.7% for 67Ga and 92.8% for MRI was found, while the specificity was 100% for the scan and 80.6% for MRI. The predictive positive value that resulted was 100% for 67Ga and 68.4% for MRI. CONCLUSIONS: Both examinations were accurate in assessing the activity of residual masses in the mediastinum after treatment. 67Ga showed a lower sensitivity in comparison with MRI, but 67Ga frequently overestimates the presence of pathologic tissue. The authors acknowledge the complementary role of these two tests, but if only one of these examinations can be performed for logistic or economic reasons, then gallium scan represents the single most adequate diagnostic procedure.

Adolescent↗
PubMed1993

Bone scintigraphy in breast cancer: a ten-year follow-up study.

Two-hundred and sixty patients with T2-T3a, pN1, M0 (TNM classification) breast cancer underwent clinical and instrumental follow-up (mean 122 months) including periodic bone scintigraphy. A total of 1971 scintigraphic examinations were performed (range 3 to 15 scintigraphies/patient, mean 8). The results of scintigraphy were compared to standard radiographs and to the clinical history of the patients. Bone metastases occurred in 71% of 122 patients who suffered from tumor recurrence during the study. Bone lesions (alone or associated with other tumor lesions) represented the most common site (42%) of first tumor relapse and occurred as first site of distant metastases in 11% of 29 patients with locoregional relapse. Bone metastases were symptomatic in 41% of cases. The sensitivity and specificity of bone scintigraphy were 98% and 95%, respectively; the positive and negative predictive values were 73% and 100%; the accuracy was 96%. Scintigraphic false positive results occurred particularly in the skull and in the ribs and generally when the examination detected less than three focal abnormalities. This study demonstrates that the number of positive scintigraphies during follow-up increases over the years, reaching a plateau only at approximately 8-10 years. It is therefore not advisable to stop performing bone scintigraphies after the first years of follow-up as this may lead to the loss of important information.

Adult↗
PubMed1991

Radioimmunoscintigraphy of ovarian cancer with the MOv18 monoclonal antibody.

The monoclonal antibody (Mab) 131I-MOv18 was administered to 30 patients with ovarian carcinoma intravenously (n = 20) and intraperitoneally (n = 10). After intraperitoneal administration, higher tumour uptake (mean values 1.3% vs. 0.8%) and a better tumour/background ratio (mean values 2.8 vs. 1.9) than after intravenous injection were obtained. Moreover, after intraperitoneal administration the uptake in non-affected organs, such as liver and spleen, was lower. However, occasionally the favourable results of the intraperitoneal route were cancelled by persistent pelvic non-specific accumulations of 131I-MOv18. The possibility to change the biodistribution pattern in the latter cases with peritoneal washing was evaluated. 3 patients were submitted to this procedure and an improvement in the radiotracer biodistribution was obtained in 1 case. With regard to tumour detection, the average sensitivity (73%) showed a significant difference from the sensitivities for abdominal (61%) and pelvic lesions (90%). No false positive results were noted.

Adult↗
PubMed1991

Immunoscintigraphy of colorectal carcinoma with an anti-CEA monoclonal antibody: a critical review.

An anti-CEA monoclonal antibody (FO23C5), belonging to the IgG1a class, was used to perform several preclinical and clinical studies on radioimmunoscintigraphy (RIS) in patients with colorectal carcinoma. Preliminary screening on different tissues showed high specificity of this antibody for gastric and colorectal carcinomas. A pilot study on 51 patients with 64 localizations of colorectal carcinoma was realized, followed by a multicenter validation study in which, among 509 patients bearing CEA secreting tumors, 254 patients had primary or relapsed colorectal tumors. High sensitivity and specificity values were obtained by these studies and many "unsuspected" localizations were recorded. In order to better define the clinical utility of this approach, a prospective trial was run on 59 patients previously submitted to surgery for colorectal carcinoma and with suspected local relapses. A comparative evaluation of RIS, CT scan, US and MRI was performed. RIS and MRI have the highest value of accuracy (86%) followed by CT scan (68%) and US (54%). No adverse reactions were noticed in any of the patients examined.

Antibodies, Monoclonal↗
PubMed1991

[Angiocardioscintigraphy in the cardiological surveillance of chemotherapy with anthracyclines].

Equilibrium angiocardioscintigraphy is a noninvasive nuclear medical method which allows cardiac function to be assessed. It is widely used in oncology since some clinically important drugs used in antitumor chemotherapy have a marked cardiotoxic effect. Angiocardioscintigraphy enables several parameters characteristic of cardiac function to be assessed, namely the left ventricular ejection fraction whose alterations during chemotherapy allow possible cardiotoxic side effects to be revealed before the development of irreversible heart failure.

Antibiotics, Antineoplastic↗
PubMed1991

Clinical protocols for the application of tests for circulating tumor markers.

Circulating marker level determination in clinical practice requires an adequate strategy of application, in view of the particular features of the parameter related to the marker. The test result, which is usually expressed in terms of concentration, cannot be considered as an absolute value because every biochemical tumor indicator expresses an activity of the tumor which generally leads to increased levels of a "normal" substance in blood or biological liquids. Therefore, the result should be interpreted as a dynamic variation occurring in time, and should always be related to a previous reference value. This means that marker determination in clinical practice should be repeated periodically, both for the evaluation of tumor response to treatment and for the detection of recurrence after radical surgery. A single measurement at the time of disease presentation can characterize the tumor with regard to its capacity of producing the signal, and consequently regarding its extent and growth. These laboratory findings are of no value whatever if they are not integrated with all the other available clinical and instrumental data concerning the neoplasm; only then can they provide useful additional information. Also, all biological variables should be taken into account which may affect circulating marker levels independently of the history of the tumor such as sex, age, clearing organ function, race, alcohol and tobacco habits, concomitant diseases. These procedural protocols should be outlined and codified for each individual neoplasm since it is useless to work with scattered data which are not ordered in some kind of procedural logic.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Neoplasm↗
PubMed1990

European multicentre study on melanoma immunoscintigraphy by means of 99mTc-labelled monoclonal antibody fragments. The European Multicentre Study Group.

A total of 493 melanoma patients were investigated by 20 European nuclear medicine departments by means of the same 99mTc-labelled immunoradiopharmaceutical and the same immunoscintigraphy (ISG) protocol. (i) No chemical or clinical toxicity was detected during or following the studies. (ii) Positive results were obtained in 287/363 (79%) patients (321 carrying known lesions and 42 carrying previously occult lesions): in 231 (80%) of them, 402/402 lesions were imaged; in the remaining 56 ISG-positive patients, 108/204 lesions were imaged; in 76 patients 0/122 lesions were imaged. (iii) The fraction of melanoma lesions visualized by ISG was 510/728 (70.1%); 605 of these lesions were already documented at the time of the study, and 123 were previously occult. (iv) A total of 218 documented melanoma lesions (30%) were not visualized by ISG in 132 patients: about 70% of the ISG-negative lesions were of small size (less than 2 cm diameter). (v) The melanoma nature of 69/123 previously occult lesions was confirmed by clinical criteria and/or additional investigations in follow-up studies. The results obtained in this study are similar to those obtained in the Italian Multicentre Study which had previously been carried out with 258 melanoma patients.

Antibodies, Monoclonal↗
PubMed1989

Immunoscintigraphy of adenocarcinomas by means of radiolabeled F(ab')2 fragments of an anti-carcinoembryonic antigen monoclonal antibody: a multicenter study.

F(ab')2 fragments of anti-carcinoembryonic antigen (CEA) monoclonal antibody F023C5, determined to be more suitable than intact IgG and Fab fragments for immunoscintigraphy, were labeled with 131I or conjugated to DTPA for instant 111In-labeling, and administered i.v. (2-3 mCi/0.5 mg) to 509 patients in 11 nuclear medicine departments: 284 patients had gastrointestinal adenocarcinomas, 204 had nongastrointestinal adenocarcinomas and 21 were control; serum CEA was elevated in 169 patients, normal in 115, and not determined in 225. The following results were obtained: (a) no adverse reactions; (b) tumor imaging in 324 patients (in particular, in 81.5% CEA-seropositive and in 69.0% CEA-seronegative patients); (c) no significant difference in sensitivity among the results of the 11 departments; (d) no significant difference in overall sensitivity between 131I-and 111In-labeled immunoradiopharmaceuticals; (e) the fraction of documented lesions imaged was 73.3% in CEA-seropositive and 53.7% in CEA-seronegative patients; (f) the detection of liver metastases was hampered, particularly when using the 111In-labeled reagent, by nonspecific radioactivity uptake; (g) the major cause of negative immunoscintigraphy results was a lack of CEA in tumor lesions, as documented by immunohistochemistry; (h) lesion size is also important since the sensitivity was 64% for lesions up to 2 cm in diameter and 84% for larger lesions; (i) many "unexpected" radiolocalizations were recorded. Most were identified as occult tumor lesions. In 35 patients, this finding contributed to the early detection of tumor recurrences.

Adenocarcinoma↗
PubMed1989

Immunoscintigraphy of melanoma using radiolabelled antibodies: pilot, prospective studies and Italian multicenter clinical trials.

The studies on radioimmunodetection of malignant melanoma reported are based on the use of the 225.28S monoclonal antibody against a high molecular weight melanoma associated antigen, an IgG2a isolated and characterized by Ferrone et al. The strategy followed by us to check the characteristics and the behaviour of this antibody and to verify its possible use in clinical praxis, includes three groups of trials performed from 1982 to 1987. A pilot study was performed on 42 patients with 74 melanoma lesions, a multicenter study was realized, with the collaboration of 10 Italian nuclear medicine centers, on 254 patients with 539 lesions and prospective study performed on 44 patients with 54 suspected regional lymph nodes involvements. High sensitivity and specificity were obtained especially with the use of technetium compound which also allowed the attainment of very high predictive values of positive tests. No adverse reactions were noticed.

Antibodies, Monoclonal↗
PubMed1988

Tumor imaging of colo-rectal carcinoma with an anti-CEA monoclonal antibody.

A 131I-labelled anti-CEA monoclonal antibody (MAb) (FO23C5) was used in a preclinical in vivo study in an animal model and in a clinical study in patients with colo-rectal carcinoma. Preliminary screening on different tissue was performed with immunoperoxidase staining, which showed a good specificity of the antibody for gastric and colo-rectal carcinoma. Initially immunoscintigraphy was performed as a pilot study at the National Cancer Institute of Milan on 51 patients with 64 localizations of colo-rectal cancer. Serial scans were performed after injection of 2 radioactive reagents, namely 131I and 111In. In vivo pharmacokinetics of the compound were studied. High sensitivity (80%) and high specificity were obtained in detecting local recurrences and abdominal metastases whereas a low positivity rate was obtained in detecting liver metastases. Our data were confirmed by preliminary results of the multicentric trial organized by the Italian National Research Council on 300 patients with about 700 localizations of CEA producing tumors.

Antibodies, Monoclonal↗
PubMed1987

Lack of efficacy of lymphoscintigraphy in detecting axillary lymph node metastases from breast cancer.

Preoperative detection of metastases in regional lymph nodes should constitute a fundamental step towards a better management of breast cancer. The National Cancer Institute of Milan has traditionally been engaged in this particular problem, that is, the search for a new imaging technique for detecting lymph nodal metastases from breast cancer. In 1984 axillary lymphoscintigraphy was performed on 26 patients with operable breast cancer by periareolar injection of 100 mu Ci of 99mTc sulphur microcolloid. The regional lymph nodes were identified as spot areas and a comparison was made between the number of primary draining axillary lymph nodes and their pathological examination. In only 2 of the 26 patients have more than 3 spot areas been revealed by axillary scintiscan, but this finding did not correspond to metastatic invasion. The lymphoscintigraphy pattern of the other 24 patients did not suggest any pathological condition. From our experience the method does not appear to help either a precise diagnosis of breast disease or the definition of the extent of mammary cancer.

Adult↗
PubMed1986

Multicenter study of immunoscintigraphy with radiolabeled monoclonal antibodies in patients with melanoma.

A multicenter study was performed to analyze the efficacy of 99mTc- and 111In-labeled F(ab')2 fragments of monoclonal antibody (MoAb) 225.28S (reactive with a high molecular weight melanoma associated antigen) to radioimage malignant lesions in patients with melanoma. A total of 254 melanoma patients, carrying 412 documented melanoma lesions, were studied in 10 nuclear medicine departments. A total of 377 lesions were visualized in 206 patients; in particular (a) 250 of 412 known lesions were visualized in 159 of 191 patients known to carry melanoma lesions; (b) 95 occult lesions were visualized in 61 patients of the same group; and (c) 32 lesions were visualized in 15 of 63 patients without diagnosed lesions. The melanomic nature of 101 of 127 radioimaged occult lesions was confirmed by clinical criteria and/or by additional laboratory investigations. These results indicate that immunoscintigraphy with radiolabeled F(ab')2 fragments of MoAb 225.28S can provide clinically useful information. Analysis of the variables influencing the outcome of immunoscintigraphy with 99mTc- and 111In-labeled F(ab')2 fragments of MoAb 225.28S confirmed the role of size, anatomic site, and level of high molecular weight melanoma associated antigen in melanoma lesions. Such analysis also showed, for the first time, the influence (a) of the isotope used to radiolabel the antibody fragments and (b) of the clinical stage of the patients. The present study has shown good agreement in the results obtained by the 10 nuclear medicine departments, suggesting that immunoscintigraphy with radiolabeled F(ab')2 fragments of MoAb 225.28S is a reliable procedure.

Antibodies, Monoclonal↗